China is developing an ethical and sustainable organ donation and procurement system based on voluntary citizen donation. The gift-of-life metaphor has begun to dominate public discussion and education about organ donation. However, ethical and legal problems remain concerning this “gift-of-life” discourse: In what sense are donated organs a “gift-of-life”? What constitutes the ultimate worth of such a gift? On whose authority should organs as a “gift-of-life” be donated? There are no universal answers to these questions; instead, responses must be compatible (...) with local cultural values. This paper argues that from a Confucian point of view, organs should be viewed as a gift from the donor’s family, and that final dispositional authority should also rest with the donor’s family. The worth of such a “gift” rests on the virtue of ren, the origin of which is family love. Ultimately, I will argue that a family-based consent model for deceased organ donation is not merely justified, but morally required in the Chinese cultural context. (shrink)

Organ trafficking is officially banned in several countries and by the main Nephrology Societies. However, this practice is widespread and is allowed or tolerated in many countries, hence, in the absence of a universal law, the caregiver may be asked for advice, placing him/her in a difficult balance between legal aspects, moral principles and ethical judgments.In spite of the Istanbul declaration, which is a widely shared position statement against organ trafficking, the controversy on mercenary organ donation is still open and (...) some experts argue against taking a negative stance. In the absence of clear evidence showing the clinical disadvantages of mercenary transplantation compared to chronic dialysis, self-determination of the patient may conflict with other ethical principles, first of all non-maleficence. The present paper was drawn up with the participation of the students, as part of the ethics course at our medical school. It discusses the situation in which the physician acts as a counselor for the patient in the way of a sort of “reverse” informed consent, in which the patient asks advice regarding a complex personal decision, and includes a peculiar application of the four principles to the donor and recipient parties. (shrink)

There exists a serious shortage of organs for transplantation in China, more so than in most Western countries. Confucianism has been commonly used as the cultural and ethical reason to explain the reluctance of Chinese and other East-Asian people to donate organs for medical purposes. It is asserted that the Confucian emphasis on xiao (filial piety) requires individuals to ensure body intactness at death. However, based on the original texts of classical Confucianism and other primary materials, we refute this popular (...) view. We base our position on the related Confucian norms of filial piety and ren (humaneness, humanity or benevolence), the tension between differentiated love and universal love, and belief in the goodness of human nature. In light of this, we argue that the Confucian ethical outlook actually calls for organ donation at an individual level, and supports an opt-out (presumed consent) system at the level of social policy. Furthermore, because the popular view is based on a number of dominant but misleading modes of thinking about cultural differences, our revisionist account of Confucian moral duties regarding organ donation has implications for developing a more adequate transcultural and global bioethics. These will be discussed and expanded upon. (shrink)

Using the 2000-2010 South Korean historical medical dramas Heo Jun, Dae Jang Geum, and Jejoongwon as case studies, this article examines televisual reimaginations of Korean medical modernity as interpretative popular culture texts. Particularly in the areas of the anatomical sciences and surgery, modern medicine’s emancipatory potentials in these productions are set semi-fictitiously in pre-modern Joseon historical contexts. Dramaturgically challenging entrenched social hierarchies and ossified cultural taboos of Institutionalized Confucianism, these dramas’ progressive physician-protagonists emphasize the universality and impartiality of medical knowledge (...) in what is herein termed as Generative Confucianism. (shrink)

Using the 2000-2010 South Korean historical medical dramas Heo Jun, Dae Jang Geum, and Jejoongwon as case studies, this article examines televisual reimaginations of Korean medical modernity as interpretative popular culture texts. Particularly in the areas of the anatomical sciences and surgery, modern medicine’s emancipatory potentials in these productions are set semi-fictitiously in pre-modern Joseon historical contexts. Dramaturgically challenging entrenched social hierarchies and ossified cultural taboos of Institutionalized Confucianism, these dramas’ progressive physician-protagonists emphasize the universality and impartiality of medical knowledge (...) in what is herein termed as Generative Confucianism. (shrink)

Using the 2000-2010 South Korean historical medical dramas Heo Jun, Dae Jang Geum, and Jejoongwon as case studies, this article examines televisual reimaginations of Korean medical modernity as interpretative popular culture texts. Particularly in the areas of the anatomical sciences and surgery, modern medicine’s emancipatory potentials in these productions are set semi-fictitiously in pre-modern Joseon historical contexts. Dramaturgically challenging entrenched social hierarchies and ossified cultural taboos of Institutionalized Confucianism, these dramas’ progressive physician-protagonists emphasize the universality and impartiality of medical knowledge (...) in what is herein termed as Generative Confucianism. (shrink)

In most, if not all, jurisdictions with active organ transplantation programs, there is a persistent desire to increase donation rates because the demand for transplantable organs exceeds the supply. China, in particular, faces an extraordinary gap between the number of organs donated by deceased donors and the number of people seeking one or more transplants. China might look to Western countries with higher donation rates to determine how best to introduce Western practices into the Chinese system. In attempting to increase (...) its organ donation rate, China must not only ensure that its organ donation system reflects different Chinese cultural values, but also that it avoids the ethical problems of the United States and of other Western systems. This article examines four such problems. They concern the family, obtaining permission for organ donation, the definition and diagnosis of “brain death,” and trust. Revisions to the Chinese system should involve a careful look to China and Chinese cultural resources rather than to Western models. (shrink)